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February 29, 2008
NPI Reminder - Medicare's Key Dates
| Date |
Implementation Steps |
Key Points |
| October 29, 2007 |
- All carriers, A/B MACs and DME MACs will be rejecting
claims where the NPI/legacy identifier combination used in
claims cannot be validated against the NPI crosswalk. Informational
edits will no longer be issued once this happens, but will
be replaced by reject reports that will assist providers
in determining why the claim is being rejected.
|
|
| March 1, 2008 |
- CMS-1500 claims must include an NPI in the primary fields
on the claim (i.e., the billing, pay-to, and rendering fields).
- You may continue to submit NPI/legacy pairs in these fields
or submit only your NPI on the claim. You may not submit
claims containing only a legacy identifier in the primary
fields.
- Failure to submit an NPI in the primary fields will result
in your claim being rejected or returned as unprocessable.
- Until further notice, you may continue to include legacy
identifiers only for the provider secondary fields.
|
Claims with only legacy identifiers in the primary
provider fields will be rejected. |
| May 23, 2008 |
- In keeping with the Contingency Guidance issued on April
3, 2007, CMS will lift its NPI contingency plan, meaning
that, for all primary and secondary provider fields, only
the NPI will be accepted and sent on all HIPAA electronic
transactions (837I, 837P, NCPDP, DDE, 276/277, 270/271 and
835), paper claims (UB-04 and CMS-1500) and SPR remittance
advice.
- The reporting of legacy identifiers will result in the
rejection of the transaction.
- CMS will also stop sending legacy identifiers on COB crossover
claims at this time.
|
If the claim contains a legacy identifier in any field,
it will be rejected. |
| NPI Resource Sheet |
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